SPEECH BY THE FIRST LADY TO THE LEAGUE OF WOMEN
VOTERS WASHINGTON, D.C. June 14, 1994

MRS. CLINTON: Thank you very much. I have been in this room to
give many speeches. I don't think I've ever seen a more enthusiastic, vocal
crowd. And I wouldn't expect anything less from members of the League who
have been leading the way for now nearly 75 years and have, in the past,
taken on difficult and controversial stands in a nonpartisan way,
putting the public's interest first, and this country owes all of you a
great debt.

I want to thank Becky for that introduction and, more
than that, for her leadership. She has been a superb representative of the
League. But I know that many of you have been speaking out and working for
positive change on behalf of our country for many years. I don't know that
there is anyone here who's been doing it for nearly 75 years, but I bet
there are some here who have been doing it for half a century or so, right?

And just look at some of the issues that you have championed and
worked for: collective bargaining; child labor laws; minimum wage
legislation; federal aid for maternal and child care programs; Social
Security; civil rights; school desegregation; the Voting Rights Act; the
Equal Rights Amendment; natural resources preservation; pro-choice
legislation; campaign finance reform; and, most recently, the Motor Voter
Act. Just listen to that list.

And for every one of those there was
controversy. For every one of those there were special interests that
were opposed to the passage of such legislation. For every one of
those, there was a long, long effort behind the final successful outcome of
the legislation.

But there isn't any issue that we have all worked
on as a country for as long as we have worked on health care reform,
because it really began in earnest when Franklin Roosevelt was President.
He believed that health care security would become the second part of
Social Security, and he was unable to get that accomplished.

President Truman, when he became President after the death of President
Roosevelt, understood intuitively that health care reform was necessary,
and twice as President, once following his accession and second after his
own election, he pushed for health care reform. You should go back and
read some of President Truman's speeches, because you could make that
today. He saw the problem. He understood the solution. And he saw what the
obstacles to achievement were.

You could look at nearly any President.
They have all tried to do something about health care. It was finally
the combination of President Kennedy and President Johnson that got us
Medicare and Medicaid, but against the same arguments that we are facing
today with health care reform. Go back and read some of the debates. You
can see it almost verbatim. And yet now here we are 60 years after
Social Security, 30 years after Medicare, finally at the brink of being
able to do what we should have done all along, and that is to achieve
comprehensive health care reform this year for our country.

You
know, it was 1911 when Carry Chapman Capp, the founder of the League,
offered some wisdom about change in America. She said, "When a just cause
reaches its flood tide, whatever stands in the way must fall before its
overwhelming power." She was talking about women's suffrage, but she
could have been talking about any of the number of movements and causes
the League has supported since its founding. She certainly could have been
talking about health care reform, because we are at a flood tide.

We are at a historic moment in our country's passage from the kind of
society that understands the importance of individual responsibility but
also the absolutely significant role that community responsibility plays in
coming together with legislation that will assure what the League has
been promoting, universal coverage, cost containment, quality benefits
for every American. And yet we know that there are many obstacles to
overcome before we will gather on the White House lawn, as we did for Motor
Voter, and sign the health care legislation together.

Last week
for the first time Congress took several significant steps toward enacting
legislation. That legislation will provide guaranteed private insurance
for every American. Senator Kennedy's bill was a very important start
in putting together the pieces for comprehensive reforms. Chairman Moynihan
in the Finance Committee is engaged in intensive negotiations. In the next
weeks, the committees on the House side will begin to roll out their
legislation as well.

Let's remember what this debate is all
about, because in the midst of the controversy surrounding health care
reform we sometimes lose track of why the League took this on as an issue,
why other nonpartisan study groups have been looking at this particular
cause for a number of years, why the President, when he was a Governor,
said that health care reform was absolutely essential for the well-being of
our country.

First of all, no American has health security.
That is the basic bottom line fact of our system. And, yes, there are
40 million now of Americans, the vast majority over 80 percent work but do
not have health insurance, but none of us in this room, no matter how well
insured, can be guaranteed we will have the same insurance this year at the
same cost next year if we do nothing to change our system. So health
security remains the primary objective, and universal coverage must be the
bottom line of any legislation.

But we also know that parts of the
problem with America's health care system is that costs have been
permitted to escalate to the point where we are not getting our money's
worth for our health care, and this is one of the difficult arguments to
make in America, where people seem to believe that the bigger and more
expensive the policy you have, the better insured you are, when there is
absolutely no relationship, and the kinds of costs that we have been
expending year after year, which are now approaching nearly 15 percent of
every dollar produced in America, have not guaranteed us better health
outcome, have not enabled us to have a secure health care system. So cost
containment must go hand in hand with universal coverage. The League
recognized that (inaudible).

You know, there are some who always
in the face of controversy look for some way out. It would be as though
when they were debating Social Security people started saying, "Well,
that's a good idea but we really ought to phase it in. We really ought to
try to make sure that the private sector first provides pensions for
everybody, and only after we've waited to see whether every company does
provide pensions should we do anything to make sure we provide Social
Security."

That is not only a very short-term approach, it is one
guaranteed to fail. We have tried to make sure people have access to good
health care in our country, and we have produced the finest health care
system in terms of the doctors and nurses and facilities in the world, but
we have failed at making it affordable and accessible to every American.
So, just as with Social Security, we cannot wait very much longer for
some miracle to occur that will enable everyone to have guaranteed
insurance without any intervention in terms of legislation.

The
League recognized that, as did other nonpartisan groups. If you go back and
look at the studies that were done up to 1992 and early 1993 by groups such
as the League, by other leadership groups, of coalitions of business and
labor and academics, if you look at the report of the Catholic Health
Association -- pick any of the nonpartisan studies that were out there
before this issue got into the political arena -- they all basically say
the very same thing, that in the absence of universal coverage you cannot
have a system that controls costs, you cannot guarantee insurance, and you
cannot be sure that every one of our systems of care, from Medicare and
Medicaid in the pubic sectors to private insurance, will sustain such a
very fragile financial footing into the future.

But what happens when
we get into the political arena? Under pressure, many of those groups, many
of those advocates begin to waiver. There are groups which, for
example, have supported the employer mandate for decades, every year voted
for it in their assemblies and their conventions, and then, in the face of
the pressure of a minority, begin to back off from what they used to
believe and what they knew was a very sensible approach to financing
health care.

I am proud that the League does not give in to such
pressure and continues to take the position of study which it knows is
right, which it knows goes beyond partisanship or ideology. You have stood
firm, and we need you now to speak even more about why you reached the
conclusions you did and take on all comers, because they cannot withstand
the scrutiny of the kind of analysis you can give their proposals.
This debate needs to be seen in its broadest context. Yes, it is a
debate about economics, because we can do better. We can save more money.
We can invest in our businesses, our families if we are not spending as
much money as we now are and are projected to spend more on health care
alone. It is about the federal budget. For the first time ever we finally
have a responsible budget, put together by a responsible President that
will enable us to have declining deficits for three years in a row, the
first time that has happened since President Truman sat in the Oval Office.

That is the good news, that we do have a very much improved
financial and budgetary system. The bad news is that health care costs are
just waiting to explode again: the increasing costs in Medicare and
Medicaid, the cost shifting, the numbers of workers who are being dropped
from employer- based insurance into those who are eligible for
government assistance. So if we do not control health care costs, then
all the work we have done to get our budgetary house in order will not work
for us. So it is a question of economics.

It is also a question of
social justice, and that is something we should talk about in our country.
It is not right that some people are denied health care because of
their financial condition. I don't believe we should go another year
and have to continue to hear the kinds of stories I have heard nearly every
day now for 16 months.

I don't think I ever want to meet another
family which tells me the story of two families living together,
siblings raising their children in a big old house, the little cousins
playing together. One cousin gets a high fever, gets taken to the hospital.
That child's parents work. They have insurance through the work place. The
child is admitted with a diagnosis of meningitis.

The other
cousin, high fever, taken to one hospital by the child's mother, who works,
single mother, divorced, raising her child. No insurance. Is sent from one
hospital to another hospital. Waits in the emergency room, filling out
forms, trying to answer questions about her eligibility possibly for
medical assistance since she has no insurance. When it's determined she
has no financial backing, she is given Baby Tylenol, takes her child home,
and the child dies.

That child has a younger sibling who also
contracts meningitis, and now the hospital that turned away the sibling
admits the child as a charity case. I don't want to hear any more stories
like that. I don't want to meet any more women who work hard every single
day, like the one I met who had had the same job for more than 15 years as
a bookkeeper, had raised her child, had sent him off to adulthood, was
still working, no insurance, but tried to take care of herself.

Went every year for a checkup, and went in for her checkup, and was told by
her doctor -- he found a lump. He referred her to a surgeon. The surgeon
said, after finding out she had no insurance, "Well, if you had insurance,
we would biopsy it, but since you don't, we'll just watch it."

I
don't want to meet any more families with catastrophic health care problems
who did have insurance but because of the extraordinary expense associated
with a premature birth with medical complications, a traumatic accident
with head injuries, a diagnosis of childhood cancer, the other problems
that could affect any one of us -- I don't want to hear any more stories
about how the lifetime limit is hit and there's no more insurance, and,
unless there's a way to finagle onto government assistance, the families
literally spend day after day looking for ways to try to finance the
health care their children need.

And I will never forget the mother
who looked at me and asked if I knew what it felt like to have a child with
a congenital illness after the insurance had run out and who knew
therefore what quality health care was like because she could afford it,
and all of a sudden finds herself on the other side, unable to afford it,
and being told one time by an insurance agent who she had gone to in a
desperate effort to piece something together which her family could afford
-- her husband was a lawyer; they were well paid, but they could not
afford what they were being asked to pay -- and finally having this agent
look at her and say, "You don't understand. We don't insure burning
houses."

I don't want to hear any more stories like that in
America. It is a simple issue of social justice that we are addressing. It
is also a question of whether or not our political system will work, and
that may be one of the hardest issues to address, but it is very difficult
as I travel around the country to explain to people why this has been so
debated and so ignored for so long where the need is increasing. And
it's because our political system has for too long been mired in gridlock
and increasing partisanship. We need to get beyond that. We need to
understand that this country is the oldest surviving democracy in the world
because when we were challenged, we were always able to respond.

My husband and I were in Europe last week. It was such an emotional and
moving time for us, because we recognized, as many of you in this audience
do, that we owe a great debt to the generation of our parents and
grandparents, some of whom have died to save democracy and our country
and our way of life; others of whom have given many years of service to
see that accomplished, and that our best honoring of them would come from
continuing their work and solving our problems and making our political
system respond.

And it strikes me that we have a clear example of
the disconnect that sometimes exists. Every member of Congress, every
member of the Administration, every federal employee is guaranteed health
care coverage and is paid for by an employer contribution matched by an
employee contribution. I believe that in politics your highest objective
should be to make sure you take care of the people who entrusted you
with their vote. And in this instance, if it is good enough for our
political system and our Congress to have universal health care coverage,
it is good.

And finally, I want to end with something that Becky
Cane told Congress on your behalf last year when she said "Access to health
care universal coverage will determine the humanity of our system, because
in the end this is also a moral issue. It is an issue that strikes very
deep into who we are as people."

We are a diverse, wonderful
collection of points of view and attitudes and backgrounds and experience.
But we need to understand we are also very much connected by our shared
humanity, and that it is time once again in America to care for each other,
to reach out and help one another. There is nothing more basic than health
care, making sure every child, every person has access to the kind of
health care that you and I always seek for our own families, knowing very
well as we look and hear about medical disasters that there, but for
the grace of God, go any of us. So, at the end of the day it is about our
humanity, about our country, and about our future, and that's why what you
are doing in fighting for health care reform is so profoundly important.
Thank you all very much.

Q Thank you. Thank you so much. I
believe there might -- the First Lady has agreed to take a few questions.
And I believe there just might accidentally be someone from Arkansas
at microphone 1.

Q Good morning, Mrs. Clinton.

MRS. CLINTON:
Hello.

Q I am Saundra Ollange (phonetic) from Fayetteville,
Arkansas.

MRS. CLINTON: Good to see you.

Q I represent the
Washington County League, and I bring greetings from Arkansas and from the
whole League. The Clinton Administration and the League of Women Voters
will support a women's right to reproductive choice. Would you give us
your thoughts on whether we should ever consider compromise on reproductive
health coverage in order to achieve comprehensive health reform?

MRS. CLINTON: Well, I think that's one of those questions that we just
cannot even answer right now, because we have to get to the forest of
universal coverage first, and I think that part of our real challenge is to
get a system that secures guaranteed health coverage for every American.
Now, we believe that should include reproductive health services. We
believe that should include mental health services. We believe that should
include preventive health services, including free preventive health
services for groups of the population who are at risk.

But the
way this whole debate is developing, it is very difficult to tell exactly
where we are going to have to make whatever compromise or where it's going
to be taken out of our hands and the Congress will basically argue it out,
as will happen on a number of these issues. So I don't think anybody is
ready to talk about compromise on any aspect. We first have to develop the
will and the support to get a financing mechanism for universal coverage,
or else everything else we want to do becomes moot. So let's focus on
getting everything possibly done to make sure we get a system for
universal coverage, and then I think we can really begin to fight out some
of the issues that will come. Thank you.

Q Thank you.

Q
Microphone 3.

Q Ms. Clinton, I am Margaret Colony (phonetic) from
Washington State. As you may be aware, the League favors a national
insurance plan financed by general (inaudible), the single payer plan. We
also support the Clinton plan as one able to provide universal coverage and
cost containment. As people learn more about the various health care plans,
they seem to like the straightforward simplicity of single payer. Do
you feel that as the public discussion moves forward, members of Congress
and others inside the Beltway will begin to see single payer as politically
feasible?

MRS. CLINTON: Not for the foreseeable future. And the
reason I say that is for two reasons. There is a tremendous amount of
education that needs to go on, which you all are engaged in, about health
care reform, and particularly with respect to single payer, because the
negative image of singe payer has been so effectively portrayed in so many
parts of our country that it will take an intensive national effort if
we were even to consider being able to get a single payer system passed
through the Congress.

Secondly, there are very distinct regional
differences in support and understanding of single payer. There are great
parts of our country that are extremely hostile to doing anything with
respect to health care reform, but particularly with respect to single
payer, in large measure because there's no experience, there are huge
numbers of uninsured, there is no experience even with organized care
of any kind, whereas if you look at the states along the Canadian border,
if you look at California, which has a lot of organized care and now has a
referendum on the ballot, there are pockets of understanding and support
for single payer, which is why in the President's bill we have an option
for states to become single payers. We really believe that
(inaudible).

But I think that is the way it would have to go, so
there would be some real practical experience that overcomes the concerns
people have. I mean, this is just a little aside, but, you know, we've had
an employer mandate financing system working in Hawaii for 20 years, and
it's very effective on not only reaching near universal coverage but also
in controlling costs.

Hawaii spends much less of its income on
health care than the rest of us do. It is so hard to get other states
even to pay attention to the Hawaii example. People are really locked into
stereotypes about health care that have been fed by very effective
information campaigns by interests that don't want change, and so that's
why I think we need to go on a state-by-state basis with single payer.
Q Thank you. Microphone 4.

Q I'm Resa Neiman (phonetic) from the
League of Women Voters of Massachusetts. Your volunteer work to shape
health care reform and to advocate for it is unparalleled. The League of
Women Voters applauds and respects public service, whether elected or
appointed, volunteer or not. But it seems to be getting nastier out there
each day. Will radio talk show hosts, ill-conceived movements like term
limits, and the media's penchant for sensationalism over substance
discourage and impede those who want to serve and make a difference?
MRS. CLINTON: That is a very important question, because it really
goes to the heart of democratic participation and willingness to take a
public stand as well as public leadership, and I think that the jury is
out. I mean, it is clear that we are in a particular phase in American
history where the penchant for sensationalism, where the desire on the part
of some to tear down instead of build up is being fed, I mean, a greater
and greater fire of destructiveness from my perspective.

And I
think that all we can do, those of us in this room who believe deeply in
democracy, who believe deeply in issues and causes, is to keep going
forward, and not be deterred and not be diverted by what are clearly
ideologically and politically motivated attacks for the large measure.
And I think if you see them that way -- in a funny sort of way, it's
perversely flattering to be the subject of such intensive hostile attack.
And the only parallel I have found in history is Eleanor Roosevelt, who I
don't even pretend to compare myself with, because I think she was
doubly remarkable for what she did at the time she did it, but she was
subjected to just incredible, just relentless attacks.

But they were
confined largely to newspaper. They weren't all-pervasive. They were not on
TV 24 hours a day. You know, they were not well organized by sort of hit
squads of people who are in this for a living. So the intensity and
pervasiveness of it seems greater, but the meanness of it, unfortunately,
has been with us for some time, and we just can't let it get to us. We just
have to believe that in the end the truth and effort and hard work and
faith pay off, and I think that's a better way to get up in the morning and
live your life anyway.

Q This will be our last question. We only
have time for one more question, one quick one. Microphone 5.

Q
Good morning. I'm Marliss Robertson (phonetic), president of the League of
Women Voters of California. (Inaudible) adopted early intervention for
children at risk as a high priority. As a respected advocate for children,
what advice can you give us to ensure the needs of children,
particularly health care needs, be given a higher priority on the public
policy agenda?

MRS. CLINTON: Well, I really commend you for taking
that on. I hope that those of you who are interested in this issue have
read the recent Carnegie report that outlines the extraordinary risks that
our youngest children are facing these days. I think that health care
reform is absolutely essential, and the kind of benefits package that we
all support, which starts with good prenatal care and well child care
and immunization, is absolutely the first step to make sure we've got good
intervention and that we have good support for families.

And the
President's work on the immunization policy which many of you helped
support, the work on extending and expanding Head Start, many of those
pieces are now falling into place, and I hope that what we can do is begin
to talk about the responsibilities of parents, and we are going to
begin that debate today. The President is going to Kansas City to talk
about welfare reform. We need to start making it very clear that there is a
mutually reinforcing system.

You know, children are the products of
both their families and their society, and too often in the past we
have separated those. And the political debate has been polarized
between people who preached at families and told families to straighten up
despite changes in the economy, despite living in neighborhoods that were
dominated by gangs and drugs and all the rest that we know, and there were
those who ignored the family and basically said the government should come
in with all of these programs and all of that.

Both of those as
single solutions are inadequate. What we need are good, positive
government programs, like health care reform, and Head Start, and other
programs like that, and responsible families. And so what we are trying
to do in this Administration is what you and I would do in a common
sense way in our own families, begin to meld those responsibilities. And
so, any work you can do talking about the need for supportive programs for
families is absolutely critical, but then also in your public and private
capacities talking about family responsibility is critical.

As my
husband says over and over again, governments don't raise children,
families do, parents do, but parents who are under a lot of stress today
could get some more support for doing that job, so that's how we need to
present this to the American public, and I think we would begin to get
more support for what we have long advocated if we were to do that.
I'd like to help you.